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TAS-102 治疗晚期实体瘤日本患者的 I 期研究。

Phase I study of TAS-102 treatment in Japanese patients with advanced solid tumours.

机构信息

Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.

出版信息

Br J Cancer. 2012 Jul 24;107(3):429-34. doi: 10.1038/bjc.2012.274. Epub 2012 Jun 26.

Abstract

BACKGROUND

TAS-102 consists of α, α, α-trifluorothymidine (TFT) and an inhibitor of thymidine phosphorylase (TPI). We conducted a dose-escalation phase I study in Japanese patients with advanced solid tumours.

METHODS

TAS-102 was administered twice daily on days 1-5 and days 8-12 in a 28-day cycle to patients with solid tumours refractory to standard chemotherapy, to determine its maximum tolerated dose (MTD), dose-limiting toxicities (DLTs), and pharmacokinetics (PKs). MTD was evaluated in cycle 1.

RESULTS

Safety and PKs were evaluated in 21 patients treated with TAS-102 at 30, 40, 50, 60, or 70 mg m(-2) per day. DLTs, such as grade 4 leucopenia, grade 4 neutropenia, and grade 4 thrombocytopenia, were observed in two patients at doses of 30 and 70 mg m(-2). α, α, α-trifluorothymidine and TPI exposures increased dose dependently, and the percentage of decrease in neutrophil count and TFT exposure were significantly correlated. The disease control rate was 50.0% with a median progression-free survival of 2.4 months in 18 colorectal cancer patients. The dose of TAS-102 was not increased above 70 mg m(-2) per day because of the increased tendency for grade 3 and 4 neutropenia, and 70 mg m(-2) per day was the recommended dose for phase II studies.

CONCLUSIONS

TAS-102 at 70 mg m(-2) per day was tolerated in Japanese patients with advanced solid tumours. Phase II studies are ongoing in patients with colorectal cancer.

摘要

背景

TAS-102 由α,α,α-三氟胸苷(TFT)和胸苷磷酸化酶抑制剂(TPI)组成。我们在日本晚期实体瘤患者中进行了一项剂量递增的 I 期研究。

方法

TAS-102 在 28 天周期的第 1-5 天和第 8-12 天每天两次给药,用于治疗对标准化疗耐药的实体瘤患者,以确定其最大耐受剂量(MTD)、剂量限制毒性(DLT)和药代动力学(PK)。在第 1 周期评估 MTD。

结果

21 例患者接受 TAS-102 治疗,剂量分别为 30、40、50、60 或 70mg/m²/天,评估了安全性和 PK。在 30 和 70mg/m²剂量下,有 2 例患者出现 4 级白细胞减少症、4 级中性粒细胞减少症和 4 级血小板减少症等 DLT。α,α,α-三氟胸苷和 TPI 暴露呈剂量依赖性增加,中性粒细胞计数下降百分比与 TFT 暴露呈显著相关。18 例结直肠癌患者的疾病控制率为 50.0%,中位无进展生存期为 2.4 个月。由于 3 级和 4 级中性粒细胞减少症的发生率增加,TAS-102 剂量未增加至 70mg/m²/天以上,70mg/m²/天为 II 期研究的推荐剂量。

结论

TAS-102 70mg/m²/天在日本晚期实体瘤患者中耐受良好。正在进行针对结直肠癌患者的 II 期研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55b0/3405214/9181c672f630/bjc2012274f1.jpg

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